Disneyland may be the "happiest place on earth," but it also one of the worst locations for a measles outbreak, as occurred a few weeks ago. There are now more than 100 cases in six states (plus Mexico) that have been traced back to the outbreak in California. This is not the first resurgence of diseases normally avoided through vaccination: New York had a measles outbreak in early 2014, and Massachusetts and California both had bouts of whooping cough near the end of the year. California's outbreak was the highest in seven decades.
Diseases like measles and whooping cough, once essentially eradicated in the United States, have resurfaced in the last few years as people increasingly choose not to vaccinate themselves or their children. In 2014, the measles and whooping cough cases in the United States rose to their highest levels in over 20 years (CDC, 5/29/14, 8/27/14). One in 10 parents choose not to vaccinate their children (Washington Post, 6/26/2014), and vaccination rates have decreased in pockets around the country. In the Santa Monica, Malibu, and Orange County neighborhoods of California, 10-15% of kindergartners are unvaccinated (CBS, 9/27/2014). When more than 8 percent of a population is not immunized, herd immunity is weakened and the disease can quickly spread. As more people choose to forgo vaccinations and these types of outbreaks continue to increase, Disneyland and other employers face the question of whether they should – or can – require employees to get vaccinated.
Most industries (with the exception of health care), including tourism, aviation, and hospitality where staff frequently encounter contagious people, do not mandate immunization. Disney has stated it will not require workers to receive routine inoculations as a condition of employment. Instead, Disney and most other companies encourage their employees to verify if they've been inoculated and, if not, offer tests and shots. The Disney employees who have not been vaccinated or could not prove their immunity status through a blood test have been put on paid leave.
Hospitals and health care facilities are a different story. States have varying laws surrounding the immunization of hospital workers; 19 have regulations requiring the MMR (Measles, Mumps, Rubella) and influenza vaccine for hospital workers. But often the policy is left up to individual hospitals. Seattle's Virginia Mason hospital was the first to require that hospital workers receive a flu shot in 2005. Kennedy Health in New Jersey recently mandated that all employees receive the flu shot unless an exemption was granted for religious or medical reasons. Nurses at the Tacoma General and Good Samaritan Hospital in Washington are suing MultiCare, which operates both facilities, for mandating the influenza vaccine. The union representing the nurses is suing based on the grounds that nurses who do not comply could be terminated.
Even inquiring about vaccination status can be tricky for employers. The Americans with Disabilities Act and the Civil Rights Act prohibit employment discrimination based on medical or religious status. Asking about whether an employee is inoculated could reveal both: some people are unable to get vaccinated due to allergies, medical conditions, or being immunocompromised, while others refuse vaccinations based on religious reasons. Mandatory vaccinations in the workplace contrast individual choice against wider public safety. Critics worry that requiring vaccinations can lead to medical and/or religious employment discrimination. However, advocates cite that a person's choice to remain unvaccinated is not restrained to the individual; the choice increases the community's chance of contracting preventable diseases, especially among vulnerable groups such as the young, the elderly, and the immunocompromised.
Readers, do you think that employers should be able to make employees get vaccinations? Comment and let us know!